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General NPI Number Information
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NPI Number | 1235216086
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Entity Type | Individual
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Provider Name | LISA E MCGUIRE MD
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 454 ST MICHAELS DR STE 200
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City | SANTE FE
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State | NM
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Zip | 87505-7602
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Country | US
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Telephone | 505-303-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PROVIDER ENROLLMENT
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone | 505-923-6770
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Fax | 505-923-5354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 57.009872
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 57.009872
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD2013-0792
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License Number State | NM
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